Main text figures
Figure 1
Spatial distribution of survey responses. (A) Number of survey respondents reporting a school age student in the household by county. (B) Percentage of households with school age children reporting any in-person schooling by county, excluding counties with fewer than 10 responses (excluded counties in dark grey). (C) Percentage of households with a child in in-person schooling reporting full-time in-person schooling, excluding counties with fewer than 10 reporting in-person schooling, (D) Average number of school-based mitigation measures reported for children with in-person schooling, excluding counties with fewer than 10 reporting in-person schooling.
Figure 2
Risk from in-person schooling and distribution of mitigation measures by grade. (A) Odds ratio of COVID-19-related outcomes associated with full- and part-time in-person schooling by outcome and grade level, compared to individuals with children in their household not attending in-person schooling and adjusted for individual- and county-level covariates (but not number of mitigation measures) indicating that the strength of the association increases with grade level. (B) Distribution of mitigation measures by grade level and full- versus part-time in-person status across all grades.
Table S4:
Adjusted and unadjusted odds ratio (OR) of COVID-19 among those engaged in full- and part-time in-person schooling versus those engaged in virtual or homeschooling outcomes. All analyses adjust for survey weights. See methods for adjustment factors.
| Schooling | Loss of taste/smell | COVID like illness | Test+ | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| adj. OR | 95% CI | OR | 95% CI | adj OR | 95% CI | OR | 95% CI | adj OR | 95% CI | OR | 95% CI | |
| Overall | ||||||||||||
| Full time in person | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
| Child_IP_full_binTRUE | 0.67 | 0.51–0.87 | 0.96 | 0.93–1.00 | 1.15 | 0.78–1.70 | 0.97 | 0.92–1.02 | 1.06 | 0.80–1.40 | 0.98 | 0.94–1.02 |
| Part time in person | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
| Child_IP_part_binTRUE | 0.83 | 0.61–1.11 | 0.99 | 0.95–1.03 | 1.17 | 0.78–1.75 | 1.00 | 0.94–1.06 | 0.91 | 0.67–1.23 | 0.94 | 0.90–0.99 |
| Grades K or under | ||||||||||||
| Full time in person | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
| Child_IP_full_binTRUE | 0.57 | 0.18–1.76 | 0.90 | 0.78–1.03 | 0.56 | 0.13–2.40 | 1.01 | 0.81–1.27 | 0.03 | 0.00–61.01 | 0.87 | 0.74–1.02 |
| Part time in person | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
| Child_IP_part_binTRUE | 0.30 | 0.05–1.81 | 1.08 | 0.91–1.27 | 2.20 | 0.26–18.83 | 1.07 | 0.85–1.34 | 1.13 | 0.11–11.29 | 0.86 | 0.71–1.03 |
| Grades 1 to 5 | ||||||||||||
| Full time in person | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
| Child_IP_full_binTRUE | 0.57 | 0.26–1.25 | 1.07 | 0.96–1.18 | 0.88 | 0.23–3.44 | 0.97 | 0.84–1.13 | 1.10 | 0.59–2.05 | 1.02 | 0.92–1.14 |
| Part time in person | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
| Child_IP_part_binTRUE | 0.60 | 0.25–1.41 | 1.01 | 0.90–1.14 | 2.58 | 0.90–7.36 | 0.96 | 0.81–1.14 | 0.86 | 0.41–1.80 | 0.94 | 0.84–1.06 |
| Grades 6 to 8 | ||||||||||||
| Full time in person | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
| Child_IP_full_binTRUE | 0.59 | 0.22–1.61 | 0.90 | 0.78–1.03 | 1,252,466,463,759.53 | 164,137,502,656.69–9,557,061,716,256.91 | 0.98 | 0.81–1.19 | 0.40 | 0.14–1.13 | 0.97 | 0.84–1.13 |
| Part time in person | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
| Child_IP_part_binTRUE | 0.65 | 0.19–2.24 | 0.90 | 0.77–1.05 | 849,225,379,765.35 | 88,978,896,177.95–8,105,110,049,862.63 | 1.00 | 0.80–1.25 | 0.24 | 0.05–1.23 | 0.88 | 0.74–1.04 |
| Grades 9 to 12 | ||||||||||||
| Full time in person | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
| Child_IP_full_binTRUE | 0.28 | 0.12–0.70 | 0.87 | 0.77–0.99 | 4.32 | 0.39–48.10 | 0.98 | 0.83–1.17 | 0.80 | 0.37–1.71 | 0.97 | 0.85–1.10 |
| Part time in person | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA | NA |
| Child_IP_part_binTRUE | 2.62 | 1.07–6.43 | 0.91 | 0.79–1.06 | 14.74 | 0.64–340.22 | 1.14 | 0.95–1.38 | 0.99 | 0.46–2.12 | 1.02 | 0.88–1.17 |
Figure 3
Impact of individual mitigation measures. (A) Relationship between number of mitigation measures and percent reporting COVID-19-related outcomes using a log-linear (solid) and spline (dashed) model. (B) Odds ratio of COVID-19-related outcomes by mitigation measure in multivariable model including all measures, versus the reduction due to a generic mitigation measure (dotted line).
Table S9
The association between mitigation measures and the off-ratio of COVID-19-related outcomes in those engaged in in-person schooling compared to those engaged in virtual- or home-schooling. Adjusted form county and individual level covariates.
| Mitigatoin | Loss of taste/smell | COVID like illness | Test+ | |||
|---|---|---|---|---|---|---|
| adj. OR | 95% CI | adj OR | 95% CI | adj OR | 95% CI | |
| student mask mandate | NA | NA | NA | NA | NA | NA |
| sch_maskMand_stTRUE | 0.96 | 0.68–1.36 | 0.74 | 0.43–1.30 | 0.78 | 0.54–1.13 |
| teacher mask mandate | NA | NA | NA | NA | NA | NA |
| sch_maskMand_tchTRUE | 0.80 | 0.56–1.14 | 1.74 | 1.03–2.94 | 0.92 | 0.64–1.34 |
| same teacher all day | NA | NA | NA | NA | NA | NA |
| sch_sameTchTRUE | 0.95 | 0.60–1.49 | 0.66 | 0.32–1.37 | 1.15 | 0.73–1.81 |
| same students all day | NA | NA | NA | NA | NA | NA |
| sch_sameStTRUE | 0.98 | 0.66–1.48 | 1.05 | 0.58–1.91 | 1.10 | 0.76–1.59 |
| outdoor instruction | NA | NA | NA | NA | NA | NA |
| sch_outdoorInstrTRUE | 0.75 | 0.37–1.52 | 0.46 | 0.11–1.93 | 1.43 | 0.68–3.02 |
| restricted entry | NA | NA | NA | NA | NA | NA |
| sch_restEntryTRUE | 0.78 | 0.54–1.13 | 1.30 | 0.77–2.22 | 0.85 | 0.58–1.24 |
| reduced class size | NA | NA | NA | NA | NA | NA |
| sch_redClassSizeTRUE | 0.93 | 0.63–1.39 | 0.60 | 0.32–1.12 | 1.18 | 0.78–1.80 |
| closed cafeteria | NA | NA | NA | NA | NA | NA |
| sch_closedCafeTRUE | 1.03 | 0.64–1.66 | 1.89 | 1.03–3.48 | 1.46 | 0.92–2.31 |
| closed playground | NA | NA | NA | NA | NA | NA |
| sch_closedPlayTRUE | 0.68 | 0.39–1.18 | 0.79 | 0.34–1.85 | 0.68 | 0.35–1.31 |
| desk shields | NA | NA | NA | NA | NA | NA |
| sch_deskShieldsTRUE | 0.60 | 0.32–1.14 | 0.63 | 0.28–1.42 | 0.98 | 0.54–1.80 |
| extra desk space | NA | NA | NA | NA | NA | NA |
| sch_xdeskSpaceTRUE | 0.88 | 0.61–1.28 | 1.43 | 0.86–2.38 | 1.36 | 0.94–1.96 |
| no extracurriculars | NA | NA | NA | NA | NA | NA |
| sch_noExtraCurrTRUE | 0.79 | 0.49–1.28 | 1.77 | 0.99–3.17 | 0.68 | 0.42–1.11 |
| no sharing supplies | NA | NA | NA | NA | NA | NA |
| sch_noShareSuppTRUE | 1.27 | 0.89–1.81 | 0.80 | 0.44–1.44 | 1.16 | 0.81–1.67 |
| daily symptom screen | NA | NA | NA | NA | NA | NA |
| sch_dailySymptScrTRUE | 1.14 | 0.78–1.66 | 1.33 | 0.75–2.35 | 1.21 | 0.83–1.78 |
| partime in-person | NA | NA | NA | NA | NA | NA |
| Child_IP_part_binTRUE | 1.12 | 0.75–1.67 | 1.22 | 0.72–2.08 | 0.86 | 0.56–1.32 |
Figure 4
Risk of in-person schooling by strata of number of reported mitigation measures. (A) Estimated risk associated with full- and part-time in-person schooling by outcome and number of mitigation measures implemented, adjusted for individual and county-level covariates. (B) Distribution of mitigation measures by total number of measures implemented.
Table S8:
Association between risk of full-time schooling and number of mitigation measures implemented after accounting for survey design and adjusting for county and individual level covariates.
| Schooling | Loss of taste/smell | COVID like illness | Test+ | |||
|---|---|---|---|---|---|---|
| adj. OR | 95% CI | adj OR | 95% CI | adj OR | 95% CI | |
| Overall | ||||||
| N mitigation measures | 0.98 | 0.90–1.05 | 1.01 | 0.91–1.14 | 1.02 | 0.94–1.11 |
| Grades K or under | ||||||
| N mitigation measures | 0.93 | 0.70–1.25 | 1.11 | 0.66–1.89 | 0.50 | 0.25–1.00 |
| Grades 1 to 5 | ||||||
| N mitigation measures | 0.85 | 0.67–1.09 | 0.84 | 0.55–1.27 | 1.32 | 1.11–1.57 |
| Grades 6 to 8 | ||||||
| N mitigation measures | 1.03 | 0.79–1.34 | 4,249.56 | 1,519.66–11,883.41 | 0.68 | 0.51–0.90 |
| Grades 9 to 12 | ||||||
| N mitigation measures | 1.33 | 1.00–1.75 | 1.07 | 0.78–1.46 | 1.29 | 1.06–1.57 |
Figure 5
Sub-group analysis of association between in-person schooling and COVID-19-related outcomes. Estimated odds ratio (versus those in strata not reporting in-person schooling) of COVID-19-related outcomes from full-time (circles, dashed lines) and part-time (triangles, dotted line) in-person schooling when data is stratified by (A) county population size and relation to metropolitan areas (metropolitan area, non-metropolitan area, adjacent to metropolitan area), (B) quintile of incidence (Q1 is lowest, Q5 is highest) and (C) propensity to report in-person schooling (Q5 most likely to have in-person schooling, Q1 least likely). Horizontal dashed and dotted lines show overall point estimates for full-time and part-time in-person instruction, respectively.